18 December 2014

Today I have released the Green Paper into the future of
health services in Tasmania.

It’s an important step in our journey of making better care
available for all.

As I move around the community I hear from patients, their
families and carers about how much respect and admiration they have for the
staff who work in our health system.

I also hear many ideas for making it better.

That’s why I announced reforms this year – One State, One
Health System, Better Outcomes reforms.

I can provide a brief update on how other aspects of the
reforms are progressing:

·Creation
of a single statewide Tasmanian Health Service by 1 July 2015 – preparations
underway and on-track for commencement on time.

·A
new Health Council of Tasmania to provide expert clinical and consumer advice
on health reform – Chaired by Denise Fassett, it was announced this week and
has met for the first time.

·Reform
of the DHHS – to focus the insight and talents of its staff on managing the
health system efficiently – underway.

The Green Paper I’ve released today describes the challenges
facing our health system and starts the conversation about finding solutions.

Central to our reform plans is the development of a Clinical
Services Profile that will describe where services can be located so that all
Tasmanians have equal and fair access to better services.

We all want to have services located near where we live and,
for many essential services; this is what we should strive for.

It’s important to recognise that we can’t always have
complex, high-risk services in all locations. It is not safe and it is
not sustainable.

Our job is to make these hard decisions about how we balance
this mix of regional and statewide services.

I urge all Tasmanians with an interest in health service
delivery to consider the details of the health Green Paper.

As you do so, please bear in mind the following:

The
Green Paper isn’t about saving money; it’s about getting better health outcomes
for all Tasmanians. No
hospitals will close and every Tasmanian community will have access to better
care. It’s
about shifting the conversation from one about better access to care to one
about access to better care.

The release of the Green Paper will be followed in the New
Year by consultation, including with Tasmanian communities and with the health
sector over the next two months.

More details of forums and meetings will be released in
coming days.

Submissions will be considered before a final White Paper on
health reform is released in March 2015, forming the basis of future action.

2. Let’s have a
conversation about the language of health - a
conversation about health - where health starts - in our everyday lives

Health is influenced by lots of things & we want to find
out what Tasmanians from all walks of life have to say about their health &
its determinants. In 2015, the Social Determinants of Health Advocacy Network -
Tasmania will oversee a project that will involve talking to people in the
community about how they understand the language of social determinants of
health (SDOH) - the language that they use and is meaningful to them.

“It is striking that anyone who uses the term “social
determinants of health” is not likely to be someone who is at risk from
them...We need a language we can all understand, and we need to hear from those
who are first in the queue to be harmed.” (Senior, T)

The project will help in unpacking a language we can all
understand, which will assist us to better engage across the range of sectors
and disciplines that are implicated in the SDOH. The project will present key
learnings about the language of SDOH, which may contribute to enhanced
community engagement and more empathetic practice. It will explore how
community insights on SDOH can enhance advocacy efforts of civil society, as
well as lobbyists working in the scientific space, to influence upstream policy
change. Lastly, it will make recommendations about the language of SDOH, and
compare findings to the work of others in this area.

We would like to hear from anyone who would like to be
involved in the development of this project. If you have ideas to contribute as
we plan for its implementation in 2015, please contact

Lifeline Tasmania is opening its 2015
intake for volunteers in the Hobart region wanting to become a Telephone Crisis
Supporter on the 13 11 14 crisis line.

Successful applicants will undertake
extensive training, make a commitment to shifts and meet further selection
criteria. This is to ensure volunteers are confident, skilled and able to
provide support to Lifeline’s Callers in their time of emotional distress and
crisis. If you’re interested, this type of volunteering will be very rewarding.

In
this guest post, Ronald Labonté traces the history of neoliberalism
through structural adjustment programs, the Great Recession and into current
Austerity Agendas. Labont é examines why neoliberalism continues to dominate
economic agendas and what types of policy messages are needed to combat the
resulting health plagues. This post is cross-posted at Global Health Watch
in support of the latest alternative world health report. Labonté holds
a Canada Research Chair in Globalization and Health Equity at the Institute of
Population Health, and is Professor in the Faculty of Medicine, University of
Ottawa; and in the Faculty of Health Sciences, Flinders University of South
Australia.

We prepared a submission to this Committee last time and
will probably do so again. If you would like to contribute please get in touch.
The deadline is Monday 16 February 2015. For the terms of reference and further
information: http://www.parliament.tas.gov.au/ctee/Joint/PHC1.htm

Southern
Rethink Mental Health Project CSO Consultation

We invite you to the Southern Rethink Mental Health Project
CSO Consultation. This consultation will be held on the 15 December 2014, 1pm –
3pm, Hockey Function Centre, 19 Bell Street, Newtown. (Please contact the
Mental Health Council to find out about consultations in other parts of the
state).

As you may be aware, the Rethink Mental Health Project is
aimed at providing an independent analysis of the current mental health
services being provided in Tasmania, and the gaps and barriers that exist
within the sector. The information gathered in this analysis will guide future
system reform and investment.

The questions that will be asked at the consultation, as
well as a more detailed overview of the Rethink Mental Health Project, are in
the Discussion paper -http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0009/173484/DP-2014-10-10_Final.pdf
. We would appreciate your consideration of this document prior to the meeting,
keeping in mind that not all areas will be covered during consultation.
Participants will be provided with information on further involvement in the
Project following the group consultation.

This set of recommendations (available in English, Spanish
or French) towards a Global Convention to protect and promote healthy diets has
been developed to encourage policy makers to build on the work of the UN to
combat obesity and non-communicable diseases (NCDs).

Ten years after the launch of the WHO Global Strategy on
Diet Physical Activity and Health, no country has succeeded in significantly
reversing the rising tide of obesity or diabetes. Cardiovascular diseases are
rapidly increasing in many lower middle-income countries. Change is urgently
needed.

When people involved in children’s feeding programs were
asked to describe them, without exception they were described using phrases
that reflected the perception of ‘wonderfulness’. This paper critically
analyses the ‘wonderfulness’ of children’s feeding programs by examining the
language used to describe these programs, and the features of a ‘wonderful’
program through an analysis of a multi-site, qualitative case study of nine
diverse programs in Atlantic Canada. When participants justified their comments
about the ‘wonderfulness’ of children’s feeding programs, they did so based
upon five perceptions of program strengths: enhanced family coping; providing
good food and nutrition; socializing and making friends; behaving well in school;
and volunteerism. We suggest that programs can be designed to be innately
‘wonderful’ if they are community- and charity-based, support a noble cause
such

as the elimination of child hunger, engage good people as
donors and volunteers, and provide a direct service to children apart from
their families. We challenge health promoters to beware of the ‘wonderful’
program; its ‘wonderfulness’ may actually be masking unintended negative
impacts upon its participants.

This third edition of Health at a Glance: Europe
presents a set of key indicators related to health status, determinants of
health, health care resources and activities, quality of care, access to care,
and health expenditure and financing in 35 European countries, including the 28
European Union member states, four candidate countries and three EFTA
countries. The selection of indicators is based largely on the European Core
Health Indicators (ECHI) shortlist, a set of indicators that has been developed
to guide the reporting of health statistics in the European Union. This is
complemented by additional indicators on quality of care, access to care and
health expenditure, building on the OECD expertise in these areas. Compared
with the previous edition, this third edition includes a greater number of ECHI
indicators, reflecting progress in the availability of comparable data in the
areas of non-medical determinants of health and access to care. It also
includes a new chapter dedicated to access to care, including selected
indicators on financial access, geographic access and timely access.

The
Wolfson Research Institute welcomed Professor Danny Dorling to deliver the
Wolfson Research Institute for Health and Wellbeing's Annual Lecture
'Health Inequalities and the 1%' on Wednesday 19 November 2014.

The 2014/15 edition examines the link between wages and
inequality at the household level. It shows that wages constitute the largest
single source of income for households with at least one member of working age
in most countries and points to changes in wages and paid employment as key
factors underlying recent trends in inequality. The report also considers wage
gaps between certain groups, such as those between women and men, migrants and
nationals, and workers in the informal and formal economy.

Inequality can be addressed through policies that affect wage distribution
directly or indirectly, as well as through fiscal redistribution. However,
increasing inequality in the labour market places a heavier burden on efforts
to reduce inequality through taxes and transfers. The report thus emphasizes
the need for combined policy action that includes minimum wages, strengthened
collective bargaining, interventions to eliminate wage gaps, the promotion of paid
employment and redistribution through taxes and transfers.

Resources,
Principles, and the Practice of Health Equity

A compilation of training resources for community health
care service providers in the Champlain region

Regional and
Remote Australians face more health care barriers

People living in outer regional or very remote areas of
Australia were more likely to face barriers to accessing health care compared
with people living in major cities. Click
here to read more.

Building a
good life: the role of natural supports in recovery from mental illness

Anglicare Tasmania, Social Action Research Centre (SARC)

One in two Australians will experience mental illness at
some point in their lives. Many, however, will live in recovery. This research
explores the lived experience of people recovering from mental illness across
Tasmania and asks them how natural supports helped them to reclaim their lives.
Natural supports are those that typically occur in everyday life and include
relationships with family, friends, peers and other social networks.

The Building
a good life research identifies the range of natural supports used by
people recovering from mental illness, explores the links between natural
supports and social inclusion and recovery, and reviews how mental health
service providers currently understand and experience their work in helping
people make the most of natural supports.

And finally, if you would like to support some improvements to the Croakey site
while also knocking off the Christmas shopping and getting yourself some nifty
public health T-shirts/mugs etc – please check out the new Croakey merchandise
range at Redbubble (you can get the designs as T-shirts, pillow case covers,
phone covers, cards, mugs etc) http://www.redbubble.com/people/rocklilydesign/collections/341262-croakey

Many thanks to Ben Harris-Roxas, Tim Senior and Lesley Russell for suggesting
the designs.

All the best
Melissa Sweet

*******************************************

This post has been compiled for the Social Determinants of
Health Network in Tasmania.

The Network has been established to
help people work together to leverage action on the Social Determinants
of Health.

The social determinants of health
are the conditions in which people are born, grow, live, work, play and age.
They are sometimes referred to as ‘the causes of the causes’ because
they are the underlying reasons why people experience poor health.

For more information about the
social determinants of health download the action sheets on the TasCOSS
website: www.tascoss.org.au.

The vision of the Network is for
All Tasmanians to have the opportunity to live a long, healthy life regardless
of their income, education, employment, gender, sexuality, capabilities,
cultural background, who they are or where they live.

Anyone who shares in this vision
can join. It’s free of charge. To join please email your details to socialdeterminantsofhealthtas@gmail.com

The Social Determinants of Health Advocacy Network held its inaugural conference in Hobart last November

Visit our website to view and download some of the presentations

Visit: http://sdohtasmania.org.au

.

What are the social determinants of health?

The word social relates to society and means people.

Determinants of health are - broadly speaking - the things that affect your health - either in a positive way (they protect our health and keep us healthy) or a negative way (they make us sick).

If we put these things together - the social determinants of health are things (systems, products, factors) created, shaped and controlled by people that affect our health.

These things include education, housing, employment, transport and so forth. These are created and shaped by people. And because if this it's possible to change them.

As an example, let's look at transport. We - the people - have created our transport systems. Not necessarily you or I personally but as a society we've done this. The problem is that there are many aspects of the system that are not great - many of our streets aren't cycle or pedestrian friendly, if you live in a rural area public transport options are limited, the number of cars on our roads isn't good for the environment and so forth. All of these things about the transport system can affect our health.

But the great thing is that, because we - the people - developed this system in the first place, we have the ability to change it - to make things better and to improve health as a result.

There are other determinants of health - such as our genes - that we can't change. So let's focus on the things we can do to improve health.

More formally, here's how the literature talks about the social determinants of health:

The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.

Here's a good place to start your reading:

A great publication on the social determinants of health is The Solid Facts.

Vision of the Network

All Tasmanians have the opportunity to live a long, healthy life regardless of their income, education, employment, gender, sexuality, capabilities, cultural background, who they are or where they live.

Membership

Membership of the Network is open to all Tasmanians who share this vision.

Membership is free of charge. Membership means you become a subscriber to our enews and that you get the opportunity to work with others who are part of this Network to undertake advocacy action.

Membership to the Network can be obtained by providing a name, organisation (where there is one but individuals can join as individuals), address, telephone and email address to the Facilitator by email:

socialdeterminantsofhealthtas@gmail.com

The Network currently has more than 220 members across Tasmania (as well as some interstate) from a broad range of sectors.

“The Commission’s main finding is straightforward. The social conditions in which people are born, live, and work are the single most important determinant of good health or ill health, of a long and productive life, or a short and miserable one. ……..This ends the debate decisively. Health care is an important determinant of health. Lifestyles are important determinants of health. ….But, let me emphasize, it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place”.

Dr Margaret Chan, Director General, World Health Organisation.

Tasmanian Action Sheets on the Social Determinants of Health

Visit the Tasmania Council of Social Service website to download 10 action sheets on the social determinants of health in Tasmania.